Flumazenil & Pain

So I know flumazenil has been known to help with withdrawal symptoms.

I've read that it can alleviate long term symptoms, but the the relief is short lived and the symptoms return.

 

My questions is...

Would flumazenil help with the withdrawal symptom of long lasting physical pain?

 

I'm thinking, if it would work for this, if it took the pain away for even a brief period of time, I would KNOW that this was withdrawal related. The pain is extremely difficult to manage, but even harder is NOT KNOWING if this is withdrawal or something else. I could withstand this all if I knew for certain it was withdrawal related. Maybe flumazenil could confirm that? ...Thoughts?

 

Hey, I read a few of your other posts and if you meant the pain in your stomach, I was thinking it may be ulcers or GI related. Maybe you should see a GI doctor if all the blood work came back normal. Same thing happened to me but I had upper right stomach pain. Not sure if yours is upper-left or in the center.

 

I don't think flumazenil will help with this.

Thanks for the reply, Mamoot!

Along with blood tests, I have had nearly every single scope and scan imaginable over the past year. Seen multiple GI doctors and specialists.

None of the tests have shown any obvious problems. None of them account for the constant, deep pain...

no - i honestly do not think it would - not sure where you've looked into getting it but my understanding - from the few places that offer it - is you are looking at $10,000 or something crazy like that.  there is nothing about the mechanism of action of it that would suggest it should do anything to alleviate stomach pain.  if you did not have the pain before withdrawal - then i would think it must be withdrawal - if you were having the pain before withdrawal - then i guess it could be something else .  you indicated you've had every test imaginable and it shows nothing - so - i think that alone would confirm that it's withdrawal.    I think one of the more experienced members here - TheWay2 tried it and he said not only did he lose a lot of money but it actually set his recovery back and caused more harm than good.....

Thank you for the level-headed advice, SSR... I didn't realize it was so expensive.

I guess, in reading so frantically across the internet since this started, I've found a lot of circles of people with pain and issues that doctors cannot account for or help with. Our medical diagnostics are far from perfect, so them not finding anything doesn't really give me the confident confirmation that would ease my mind... But alas, you're probably right, as anything else I've tried has only made matters worse. Guess I'll just have to be patient.

 

 

Flumazenil infusions may help heal the brain during post acute withdrawal by up regulating GABAA receptors. I read something about a nasal spray version of Flumazenil. But nothing is available in the US like this yet. Flumazenil seems like it might help us but you can only get it as a rapid detox, which is the least helpful form of its usefulness in treating benzo wd long term. It is useful for reducing tolerance. For instance, if you were on a high dose of a benzo, you can reduce your dosage and tolerance level comfortably at a rapid pace. Too bad hospitals are not trained and educated on its uses because it may be a solution to this problem. I don't know though. Wishful thinking maybe. I'd like to get a nasal spray version of it and try it on myself to treat my PAWS.

 

I found this link that explains how one doctor or guy is treating benzo withdrawal with flumazenil.

 

https://mosaicscience.com/story/blocking-the-high/

 

I attempted to order Anexate 0,5 Inj.-Lsg 5 Amp. 0.5 mg 5x5ml. This is Roche Flumazenil vials. Not sure how much I need but I'm kind of curious if a nasal spray will work now. I figure if I add 5ml of dH2O to 5ml of Flumazenil 0.5mg and put it in a 10ml nasal spray bottle it may be helpful.

I was able to order that flumazenil. It said it shipped. Not really sure what I'm going to do with it now. I kind of have my doubts over it, and also not sure if I want to make a nasal spray with it because of the inactive ingredients in the vial. Now I'm not sure how the hell I'm supposed to administer this on my myself because of the rapid half life. Not sure if there a permanent benefits if I use it either. I think I need to use extremely small doses throughout the day for several weeks to get some kind of benefit. I'd like to use it daily for at least 4 weeks.

 

Edit: after reading it seems that larger dosages may be required for sublingual administration of flumazenil. I wonder the intranasal dosage is similar to IV. I may just need to inject it if I want to use it. If I start using it I may just try it for 3 days in a row at first or even 1 day to see if it triggers waves or any negative responses. I ordered this from an online pharmacy in Germany. I had to fill out some request form that a doctor looked at. It asked my diagnoses and I stated: benzodiazepine post acute withdrawal syndrome in the online form. It was approved pretty much right away. It seems legit so far and the medicine seems like its going to be authentic. Hopefully it isn't some Indian knockoff because I paid extra for these Roche vials. It was under 200 dollars for 5, 5ml, 0.5mg vials. A lot cheaper than the Coleman institute if I can figure out how to use it correctly.

Keep us informed.... I know you will.  But please be careful, too.

 

-RST

Hey RST. Yeah I'll be careful. I'm already a little discouraged because I'm not really sure what dosage to use and how often I should inject it. I read somewhere that the pH of the Roche preparation, Anexate is not suitable for subcutaneous injection. It is too acidic I guess. These vials I'm getting have 0.5mg of flumazenil in them. I'm thinking to inject, 0.05mg three-five times a day to see if this provides a benefit. If it doesn't provide a benefit at that dosage, I will increase it to 0.1mg three-five times a day. I started looking into a portable syringe pump but it seems expensive and too complex to get into. If anyone has any ideas for an IV pump that would be helpful. In order to make this work I may need to eventually buy some type of IV pump and get the 1mg vials. This is going to be complicated. Maybe it wasn't such a good idea but what if Flumazenil really resets the BZD binding sites and helps us recover faster...it isn't fair that this medication isn't widely available if it really helps, which it seems to be the case.

 

Edit: I have an idea that maybe I can just leave the syringe in my vein all day with medical tape and just inject whatever I need throughout the day. Pretty ridiculous though. I just don't want to inject flumazenil in my veins multiple times a day.

Is there any chance that you could find a medical professional who could insert a port for you so that at least you don’t have to keep jabbing yourself.

 

They do use an implantable pump at the Australian clinic, query whether that is something you could buy & do yourself.

 

Did you consider making up a nasal spray, although I don’t know if it has the same efficacy as the injection.

 

Are you still taking the phenibut? It does have a short half life but if any remains in your system, the flumazenil may bump it off the gaba receptors with potential withdrawals.

 

I hope it works well for you whatever you decide. It would be so great to see someone have a big turnaround in symptoms.

It was my original desire to make a nasal spray with it but it is not a good idea because of the inactive ingredients and the acidity of the solution in these vials I'm getting. It is not even approved for subcutaneous injection because of the acidity. If I could source pure Flumazenil powder I could make a nasal spray easily. Maybe not that easily because Flumazenil is not soluble in water either. Phenibut or gabapenitin shouldn't interact much with Flumazenil because they don't have affinity for the benzodiazepine binding site. Flumazenil is really specific to benzos only so other drugs will not interact much. Also, I will be injecting very small dosages.

 

It may interact with gabapentinoids like phenibut and gabapentin because of this case study here. In small dosages it may help me taper these drugs but I'm not sure:

 

Abstract

OBJECTIVE:

To describe a case of gabapentin-induced coma that was reversed with flumazenil and hemodialysis.

CASE SUMMARY:

We describe an 83-year-old dialysis-dependent white man who became comatose after a single dose of gabapentin for phantom limb pain. The patient was successfully revived from the coma with administration of flumazenil, which was then followed by hemodialysis. Serum concentration data before and 4 hours after dialysis document the effectiveness of hemodialysis for gabapentin toxicity.

 

https://www.ncbi.nlm.nih.gov/pubmed/12503937

 

I like the idea of a injection port. I should find something on ebay. Thanks for the advice.

You will need the port. By the way, the following article talks about the very acidity issue you mention and speaks to other aspects of flumazenil generally.  Perhaps you've read it already but if not, it is interesting.  Of particular interest might be the information on dosing they used.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014019/

 

If you are not on an SSRI, there may be a future in transcranial direct current stimulation (tDCs) as a means to influence LTP/LTD of neurons.  In some studies, the models seem to suggest that cathodal tDCs can cause LTD, which may undo the LTP that perpetuates the glutamate storm.  However, like so many of these things, there may be issues due to our trend to be on other drugs to help with the agony and said drugs may cause unforseen outcomes.  For example, cathodal tDCs tends to be reversed by the presence of incremental increases in serotonin (as a result of ssri dosing; paxil, effexor etc).  Most of this work is related to memory formation but since the idea that long term potentiation (LTP) is a functional issue for our lengthy withdrawal looking tDCs has some interest.  For some information on tDCs, see the following:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127836/

 

Please keep in mind, my science knowledge is limited so I'm just giving some broad strokes here. 

Transcranial direct current stimulation seems like it may be helpful. One of my concerns with flumazenil is that it will act like a benzo and set me back since it is a partial agonist. My hope is that it nets a positive effect and speeds up my recovery. I think it will temporarily eliminate PAWS though instantly from what I read.

So, I checked the tracking info and the flumazenil I ordered should be coming soon. I ordered IV ports too which are coming soon too. Ever since drinking those 5 beers I had a few weeks ago Ive been messed up, constantly obsessing about my broken, busted up toe that has gotten worse actually because I keep messing with it. Not really sure what to expect from the flumazenil. Mostly I just want to try it out for one day and see if it helps or makes things worse. It may be another few weeks at the most until I try it though. Maybe sooner since I have no patience. My gabapentin and phenibut situation is not the way it should be. Dosing schedule is off and I'm back at 1500mg of gabapentin too as well as 2.5g of phenibut because of the beer and my toe.

Good luck if you do try it. I note your concern about the flumazenil specificity for the benzo receptors only & hope it doesn’t interact unfavourably with the gabapentin or phenibut. Please stay safe

So, I checked the tracking info and the flumazenil I ordered should be coming soon. I ordered IV ports too which are coming soon too. Ever since drinking those 5 beers I had a few weeks ago Ive been messed up, constantly obsessing about my broken, busted up toe that has gotten worse actually because I keep messing with it. Not really sure what to expect from the flumazenil. Mostly I just want to try it out for one day and see if it helps or makes things worse. It may be another few weeks at the most until I try it though. Maybe sooner since I have no patience. My gabapentin and phenibut situation is not the way it should be. Dosing schedule is off and I'm back at 1500mg of gabapentin too as well as 2.5g of phenibut because of the beer and my toe.

 

We're here along for the ride with you, Mamoot!!  As has been said otherwise, be careful and let us know how it goes. 

 

RST

I stumbled on something that has me worried. Since tianeptine is technically a tricyclic antidepressant and there is a major interaction with flumazenil and amitriptyline not sure if mixing these two will hurt me. Tianepine works differently but I don't know for sure if mixing it will be a disaster. I'm pretty sure it won't interact but I can't risk it. I'm going to have to stop taking tianeptine first and that isn't any time in the next few weeks. This sucks.

 

https://www.ncbi.nlm.nih.gov/pubmed/1460591

Hmmmn.

 

Here is another article on the topic:

 

https://www.ncbi.nlm.nih.gov/pubmed/1586424

 

Interestingly, the above noted article describes dogs that had been subject to amitriptyline overdose.  The midazolam was used to treat the amitriptyline issue by sedation and then the flumazenil to rapidly reduce the midazolam effects.

 

I don't think you are taking seizure inducing doses of tianeptine nor are you dosing anything else that could cause sedation to the point of unconciousness but obviously you (and all of us) want you to err on the side of caution. 

 

We should all keep talking and keep helping each other with research and sharing of ideas.  Perhaps by putting our collective heads together we can get to a clearer picture on the matter.

 

-RST

I'm down to 25mg of Tianeptine sulfate. I ended up taking some tramadol for a few days to reduce my dose from 100mg, tianeptine daily. I hated the tramadol. I ended up taking a little kratom and I feel a good amount of relief from my depression. So, I'm going to continue taking the kratom for a little while and stop taking tianeptine and everything else extra that I've been taking. Hopefully soon I can just be on gabapentin and phenibut and then try out the flumazenil to see if it gives me any relief. But I feel better overall now. It seems the situation with my toe is getting better and I'm going to find out what's going to happen soon as far as if anything serious is going on with it.

I'm down to 25mg of Tianeptine sulfate. I ended up taking some tramadol for a few days to reduce my dose from 100mg, tianeptine daily. I hated the tramadol. I ended up taking a little kratom and I feel a good amount of relief from my depression. So, I'm going to continue taking the kratom for a little while and stop taking tianeptine and everything else extra that I've been taking. Hopefully soon I can just be on gabapentin and phenibut and then try out the flumazenil to see if it gives me any relief. But I feel better overall now. It seems the situation with my toe is getting better and I'm going to find out what's going to happen soon as far as if anything serious is going on with it.

 

Good news on the tianeptine.  Thanks for the update.  I've been wondering about how you were (are) doing.  One step at a time, as they say.

 

-RST

I'm going to find out about my toe today. Had an MRI done on my foot a few days ago too. The images were a little blurry because I couldn't keep my foot perfectly still but they said they got a result. I think I took my last dose of tianeptine today. The kratom is reducing my anxiety a lot better than tianeptine was and I'm on a pretty low dose of it....just 3g of red vein maeng da once daily. I'm going to stay on kratom short-term though but I can finally see things clear enough to know that I've gone crazy with anxiety and stress recently from my toe. Ever since I posted that thread about me drinking those beers at the end of January, it has been non-stop stressing over it. I can't wait for the podiatrist to just tell me it is going to be okay and this surgery fear goes away. Everybody I know, including my doctor and psychologist thinks I won't need surgery...just don't understand why the orthopedic made that "you may need to get cut open" comment when I showed him that my toe looked crooked in the x-ray...not the bone-structure but the actual toe is out of position. Not sure how common this is with traumatic fractures. I never broke my toe before so this is all new and scary to me with my benzo wd anxiety in full tilt. The way things are going I should be able to try out the flumazenil soon hopefully.

I'm going to find out about my toe today. Had an MRI done on my foot a few days ago too. The images were a little blurry because I couldn't keep my foot perfectly still but they said they got a result. I think I took my last dose of tianeptine today. The kratom is reducing my anxiety a lot better than tianeptine was and I'm on a pretty low dose of it....just 3g of red vein maeng da once daily. I'm going to stay on kratom short-term though but I can finally see things clear enough to know that I've gone crazy with anxiety and stress recently from my toe. Ever since I posted that thread about me drinking those beers at the end of January, it has been non-stop stressing over it. I can't wait for the podiatrist to just tell me it is going to be okay and this surgery fear goes away. Everybody I know, including my doctor and psychologist thinks I won't need surgery...just don't understand why the orthopedic made that "you may need to get cut open" comment when I showed him that my toe looked crooked in the x-ray...not the bone-structure but the actual toe is out of position. Not sure how common this is with traumatic fractures. I never broke my toe before so this is all new and scary to me with my benzo wd anxiety in full tilt. The way things are going I should be able to try out the flumazenil soon hopefully.

 

Here's hoping your foot is..........'toe-tally'........fine  :laugh:

 

Glad to hear you are doing fine with the tianeptine, too.  Woohoo, Mamoot!!!

 

Cheers,

 

-RST

Haha RST. Everything was normal on the MRI except I have metatarsophalangeal joint MTP Capsulitis. Something, I suspected pretty much the entire time except I didn't know what it was called exactly. I asked why my toe drifted or appears dislocated and he didn't have much to say except that it looked beautiful and it's healing. It annoyed me a little and he didn't seem very concerned with it. I looked up capsulitis online and the condition also seems to be called "predislocation syndrome" in the second toe or elsewhere, not sure. My toe is still lined up nicely but it's just dipping a bit. Apparently, I'm the only one who is concerned about it considering a medical professional called my injury "a beautiful toe"...maybe I lost my sense of humor a long time ago and need to just relax and let the damn toe heal now. I'm thinking really healthy diet and BPC-157 will make me feel more positive about it and put more effort in meditation again and exercising. Don't know about you guys but I find it extremely difficult to meditate and breath correctly or just relax about anything right now.

 

Basically, the inflammation in the joint capsule is weakening the ligaments and this may have caused the toe to shift a bit. I couldn't get confirmation from the doctor if that was the case because he just said it was a beautiful toe. It's a beautiful toe, nuff said....feels like I'm in a cartoon sometimes. I have a follow up appointment in two months.

 

I saw some some friends yesterday. Spoke to my friend who used to take benzos and asked him more questions about how much and how often he used and if he had alcohol or food sensitivities. He said Xanax for about 10 years with basically no breaks and well over 10mg some days. He used high dosages all the time. He basically quit cold turkey too. He is fully recovered after 3 years, 100% he said and never worried about the whole healing process. He even drank beers too throughout the entire early stages of recovery and claimed it helped him. He said it was really hard the first year but his experience seems totally different than the common benzobuddy. He even kept his job. Didn't lose any friends either or anything that I lost. I lost my mind. He was hooked on other drugs too. He thinks I'm blowing this whole alcohol wave stuff out of proportion but I don't think I am. Not sure what is wrong with me or us. I want to blame benzobuddies for brainwashing me but I don't know where to put the blame anymore for what's happening to us. I think I need to get out of the house more often though. I can't stay home anymore all the time and just text people. My friends party often and I have to just sit and watch and feel uncomfortable about everything. Like everything....when they talk about their jobs...social lives....etc...it hurts me so much because I lost all that stuff. Even when they drink and use recreational drugs I feel like I'm missing out but have no desire to use anything like alcohol or cocaine or whatever because it all makes me sick now.

 

I quit tianeptine today. I'll just take the kratom for a little bit and just try to get off the gabapentin and phenibut again when I'm ready to...but probably the gabapentin first...not sure if I can taper both at the same time anymore. The flumazenil isn't going to work unless I chronically administer it for at least a few days I'm thinking....I'm hoping to basically reset the DNA of these receptor sites and jump-start the molecular switch into the healing zone but not sure how effective this is or how often I should do it. I'm just hoping that it helps with waves and to be able to use it short-term for a few days and just stop. I'm obviously hoping it will help me taper the gabapentin too but I don't know. It's not like I have that much flumazenil either. I will have to keep ordering more and it's really expensive. Also, the vials are not re-usable. They are the break-away glass, single use which really bummed me out. I'll have to figure out a way to store it properly if I don't use the entire vial in one day, which is 0.5mg.

I hear ya, Mamoot.  At the end of the day, we all are on our own path.  We have shared realities in some ways but the core of our experience is based on our individual pain and our ability to deal with it.  This is one of the things that is challenging for me because I don't know what the future holds in terms of tapering.  If I knew that I would have to face 6 more months of hell and then I could rebuild my life I could handle that a lot easier than dealing with the unpredictable that I (we) face.

 

This is part of the dilemma around friends, social life, etcetera.  I cannot commit to anything because I don't know if I'll be on my back in a darkened room trying to stand the burning pain and standing up my friends who've planned to have us over for dinner.  I'm also a father and a husband.  My family has to come before everything.  Moreover, I've managed to hide the truth of my struggles from my 13 year old son.  He is already an anxious person and I will not do anything to negatively affect him or my wife.  Furthermore, I'm still working as I am the breadwinner in our family.  Some days my exhaustion is absolutely shocking.

 

Your comments remind me of moments when l feel like everything we are dealing with is such an incredible waste of our precious and limited time.  Such thoughts aren’t healthy, but they are natural.  I also get angry with myself for not taking more care in making the fateful decision to take Ativan for insomnia, and the irony of stopping after only 11 days and being both dependent on it and in inter dose withdrawal.  But this is our reality, those were the decisions that were made and now it’s all about going forward.  I turned 49 years old this year.  I don’t want to be thinking about my gabapentin taper in the same way a year from now.  But, at the pace I am going, that is likely.  I have to accept it and try to build a life within these circumstances.  I’m doing that with the support of my wife.  That’s all we can do.  I find focusing on anything that we can do is what keeps me mentally centered and helps me define success.

 

I say without any sense of ego that I used to be in great shape physically.  Now, my muscles have changed and my hair loss has rapidly accelerated.  I expect that by next fall I will have to do a crop cut or shave my head as I can’t take the Dr. Phil look, which is what I am rapidly developing.  I am 6 feet 1.5 inches tall.  My weight has always been a lean but muscular 205 pds.  I’ve lost 20 pounds of muscle, as I essentially had the least amount of body fat possible there was no fat to lose.  But when I look in the mirror, I have to accept it and buy new clothes to deal with it.

 

I guess I would say, do what you can.  Make time for friends when you can and do everything possible to keep active and engaged in life.  I was a lifelong athlete and desperately miss training in Brazillian Jiu Jitsu and downhill Mountain Biking.  I can’t do those things anymore although I hope to return to them someday.  I can’t do much exercise at all as it seems to really mess up my HPA axis and then throw me into a terrible increase in symptoms.  However, I walk.  I have gone from high level of sport competitiveness to being satisfied with a good walk of 8 or 10 blocks.  I guess I am saying that we need to find success where we can.  Life is worth living.

 

Forgive me for rambling on this post, I hope there is something in it that merits its reading.

 

All the best,  :thumbsup:

 

-RST

 

Rambling is okay RST. I'm a rambling man. I had to start shaving my head and all this has accelerated my male pattern baldness. I'm only 33. I'm debating getting a hair piece one day now because I don't feel comfortable with this look which is something that gives me anxiety. I have issues with being bald. I don't look bad but I just think I look way better with hair. But if the hair piece is obvious I can't wear it because that will give me anxiety. I'll probably start wearing hats on top of the wig and only show the wig when I had no choice. Because wearing a hat with a shaved head doesn't look as good as having hair on the sides of your head with a hat on. It's no comparison.  You need to start wearing skull caps. The whole thing just really sucks. Going bald fucking sucks. Especially when you took such pride in your looks and appearance. What a curse. It's hard to stay lean too now. I'm trying to get in shape at the gym but it is hard. I'm 18% body fat right now at 6' about 180lbs...not exactly a big guy....and I need to gain more muscle. I just feel like I don't look good. I lost a lot of muscle mass.

 

I'm taking several peptides right now as of two days ago. I'm starting to feel better and it's working well. BPC-157, delta sleep inducing peptide, GHK-Cu, and P21. I'm hoping to heal my injuries and stay off the tianeptine and get off the kratom real soon, in about 4 days. I'm going to keep going to the gym and try to eat as clean as possible. I'm hoping for a really good window to open up for me and sustain it once I'm off the peptides. I can't mess it up this time. I need forward progress. Once I lay a good foundation, I will test out the flumazenil. I haven't been sleeping well these past few days. I just have too much restless energy and missed a few naps that I'm used to taking, trying to adjust to a new sleep schedule, and other things like my friend wanting to meet up which ruined my opportunity to take a nap. Not sure if it is from working out or not too but sleep is escaping me. Going to the gym is important because I get out of the house.

 

You're doing good RST. You'll get through this one day. Do you think I will? I keep fearing that I took too many drugs and I will never recover.